Determinants of Satisfaction With Hospital Online Appointment Service Among Older Adults During the COVID-19 Pandemic: A Cross-Sectional Study

Exploration on the development of public hospital-sponsored telemedicine platform: A case study in China

BACKGROUND

As a result of recent advancements, Internet hospitals have been a typic kind of telemedicine platform in China. The platforms can now provide a wide range of medical services while breaking through the limitations of time and space with excellent accessibility.

OBJECTIVE

This study aims to give a comprehensive description on the role extension of a public hospital-sponsored Internet hospital in China from the aspects of the characteristics, patient's benefit and satisfaction, the workload of pharmacists and pharmaceutical care.

METHODS

The total number of online prescriptions and detailed information were obtained automatically from the Internet hospital information system from Huashan Hospital Fudan University. Age, sex, associated prescription departments, time of prescription, payment methods, expenditure, drug category and delivery region were included in the analysis. A follow-up questionnaire was distributed as an electronic form that was collected and analyzed through the Internet to evaluate patients' satisfaction and time/economic benefits.

RESULTS

A total of 51,777 patients visited Internet hospital and purchased required drugs from May 2020 to March 2022. The top 5 online prescription departments were dermatology (83.11%), neurology (6.85%), infectious diseases (3.27%), gastroenterology (2.35%) and cardiology (2.03%) departments. During this period, the audit pharmacists reviewed an average of 240 prescriptions per day, and the consultant pharmacists replied to about 42 consultations per day. 77.89% patients living in westsourth China benefited most from the Internet hospitals. They saved longest time (5 days) and the most expenses ($450-600). We observed an average patient satisfaction score higher than 4.5 in majority dimensions, including drug accessibility, effective in communication and confidence in medical staff. During closed-off management period between April to May in 2022, a total of 194,388 drugs were prescribed and delivered to 19,442 patients with the total payments of $1,547,001.2. Compared with those before closed-off management, the proportion of patients visiting dermatology department reduced from 83.11% to 54.87%. There was a significant increase in the number of patients visited general practice medicine department. The pharmacists extended their working hours by 5 h per day. In 2 months close-off management, the audit pharmacists reviewed an average of 320 prescriptions per day, and the consultant pharmacists replied to about 138 consultations per day.

CONCLUSIONS

The characteristics of patients in terms of department and disease profiles in the Internet hospital were consistent with those preponderant disciplines in the entity hospital. Patients benefited from the Internet hospital not only in saving times, but also in reducing medical expenses. During the close-off management period, the distribution of departments and disease profiles changed dramatically. These changes indicated that the Internet hospital was no longer just an extension of in-hospital services, but played an important role in fighting the epidemic, changed the mode of patients' medical treatment and hospital diagnosis and treatment at special times.

How Expectations and Trust in Telemedicine Contribute to Older Adults' Sense of Control: An Empirical Study

As numerous nations transition into digital and aging societies, the digital divide has emerged as a significant impediment to older adults' autonomous engagement in the digital society. Enhancing the well-being of elderly individuals through remote medical technology represents a prevailing and prospective trend. Nevertheless, remote medical technology extends beyond the realm of healthcare, offering promise for narrowing the digital divide through the deployment of digital devices and provision of intergenerational support. Therefore, this study investigates the role of trust and expectations in the use of telemedicine, indicating potential pathways for how these products can improve older adults' daily living abilities. Through the construction of a theoretical model, we collected the relevant data of 661 elderly people who use telemedicine technology in China and analyzed the data with SmartPLS4 to obtain the research results. The study discovered that, among older people using telemedicine technology, (1) healthcare expectations promote the breadth of telemedicine product use; (2) trust in product safety increases the depth of telemedicine product use; (3) trust in the service provider promotes the breadth of telemedicine product use; and (4) when compared to the depth of product use, the breadth of telemedicine product use increases older adults' sense of control over their digital lives. The findings provide new empirical data to support growing beliefs about how expectations and trust can increase a sense of control over one's life. They also provide practical contributions on how to boost older adults' usage of telemedicine products, promote their digital literacy and competency, and enhance their sense of control over their digital lives.

Association between residential proximity to major roadways and chronic multimorbidity among Chinese older adults: a nationwide cross-sectional study

BACKGROUND

Multiple negative health outcomes were linked to residential proximity to major roadways. Nevertheless, there is limited knowledge regarding the association between residential proximity to major roadways and chronic multimorbidity.

METHODS

We used data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, which included 12,214 individuals aged ≥ 60. We derived the residential proximity to major roadways from self-reported data, defining chronic multimorbidity as the presence of two or more concurrent chronic diseases. A binary logistic regression model was utilized to investigate the association between residential proximity to major roadways and chronic multimorbidity. The model accounted for some demographic features, socioeconomic conditions, social participation, and health conditions. Subsequently, we conducted subgroup analyses to examine potential interaction effects.

RESULTS

Residential proximity to major roadways was associated with chronic multimorbidity, even after adjusting for confounding factors. Compared with those living > 300 m from major roadways, the OR for those living 201-300 m, 101-200 m, 50-100 m, and < 50 m were increased. When subgroup analyses were conducted using a cutoff point of 200 m, the risk of chronic multimorbidity associated with residential proximity to major roadways was stronger in participants with education levels > 6 years (P = 0.017).

CONCLUSION

Our findings provide important implications for improving residential area siting, transportation policies, and environmental regulations to reduce the risk of chronic multimorbidity caused by traffic-related exposure.

Factors affecting the willingness of patients with type 2 diabetes to use digital disease management applications: a cross-sectional study

Background

The global burden of type 2 diabetes has significantly increased, leading to a considerable impact on healthcare systems worldwide. While the advent of mobile healthcare has provided some relief by addressing the shortage of certain medical resources, its adoption among the Chinese population remains relatively low. To extend the benefits of mHealth to a greater number of Chinese diabetic patients, it is essential to investigate the factors that influence their willingness to utilize it and implement targeted interventions based on these influencing factors. The Technology Acceptance Model (TAM) is widely employed to examine users' ultimate usage behaviors, and previous studies have indicated the potential relevance of the Perceived Risk (PR) theory and the eHealth Literacy Theory to users' usage behaviors.

Objective

Our objective was to investigate the determinants that affect the willingness of Chinese patients diagnosed with type 2 diabetes patients to utilize digital disease management applications (DDMAs).

Methods

We conducted a cross-sectional study of patients with type 2 diabetes in three tertiary general hospitals in Chengdu using questionnaires designed by the investigators. Participants were sampled using a convenience sampling method. The questionnaire comprised three sections: socio-demographic profile and medical history; current awareness and willingness to use digital disease management applications; and the current level of e-health literacy. Structural equation modeling was employed to assess the impact of patient awareness of DDMAs and e-health literacy on the willingness to use such DDMAs.

Results

(1) Patients' attitudes toward using DDMAs were significantly influenced by perceived ease of use (β = 0.380, P < 0.001) and perceived usefulness (β = 0.546, P < 0.001); (2) Electronic health literacy exerted a significant impact on patients' perceived usefulness (β = 0.115, P = 0.018) and perceived ease of use (β = 0.659, P < 0.001); (3) Patients' willingness to use was significantly influenced by perceived usefulness (β = 0.137, P < 0.001) and use attitude (β = 0.825, P < 0.001).

Conclusions

The present research findings hold both theoretical and practical significance, and can serve as a guide for healthcare practitioners and researchers to gain a deeper comprehension of the acceptance of digital disease management applications (DDMAs) among type 2 diabetes patients.

Evaluation of Patient Satisfaction With the New Web-Based Medical Appointment Systems "Mawid" at Primary Health Care Level in Southwest Saudi Arabia: A Cross-Sectional Study

Background Patient satisfaction has become an influential corner in the health services process. Web-based appointment scheduling has been expanded for its benefits and has become a popular research topic. This study's objectives were to assess patients' satisfaction and perception with the new Web-Based Medical Appointment System "Mawid" program and determine the associated factors at the Primary Health Care Centers level in Jazan Southwest Saudi Arabia. Methods An observational cross-sectional survey was implemented among 424 adults aged 18 years and above, attending a randomly selected 12 primary health care centers in the Jizan region, Southwest Saudi Arabia. The study instrument included socio-demographic background information, perception, and level of satisfaction with the new appointment system. Responses were analyzed using the SPSS program by applying descriptive and inferential statistical techniques. Results The overall level of satisfaction was very high at 94.3% with 95% C.I. (91.7-96.1). A large proportion of study participants were highly satisfied with the new Web-Based Medical appointment System "Mawid" as nine satisfaction items scored a level of satisfaction of 90% and above. Regarding the perception, 89.1% of the participants agreed that the appointment booking system regulates the number of patients, while 87.7% of participants considered that the appointment system reduces clinic crowding. More than half of respondents (61.8%) agreed that the community culture might limit the scheduling system's use. Univariate and multivariate logistic regression analysis suggested that male patients were more likely to have a higher level of satisfaction as compared with female (COR= 2.95, 95% C.I.:1.15-7.60, p = 0.025) and (AOR= 3.12, 95% C.I:1.14-8.52, p = 0.026), respectively. Conclusions In conclusion, this study revealed a high level of satisfaction among study the participants with the new Web-Based Medical Appointment System "Mawid." The system effectively improved patients' satisfaction with registration and reduced waiting times. Patients' satisfaction can be assessed regularly and used systematically as a quality and benchmarking instrument in primary health care.